Category: Statistics

PLoS One. 2021 Apr 29;16(4):e0250872. doi: 10.1371/journal.pone.0250872. eCollection 2021.

ABSTRACT

BACKGROUND: Risk communication is a key component of public health interventions during an outbreak. As the coronavirus pandemic unfolded in late 2019, the World Health Organization (WHO) was at the forefront in the development of risk communication strategies. The WHO introduced a range of activities with the purpose of enabling the public to avail verified and timely information on COVID-19 prevention behaviors. Given the various WHO activities to protect the public health during COVID-19, it is important to investigate the extent of familiarity and uptake of the WHO recommendations among the public during the first wave of the pandemic.

METHODS: To do this, we conducted a large-scale Pan-European survey covering around 7500 individuals that are representative of populations from seven European countries, collected online during April 2-April 15, 2020. We use descriptive statistics including proportions and correlations and graphical representations such as bar charts to analyze and display the data.

RESULTS: Our findings suggest that information from the WHO in the context of COVID-19 is well trusted and acted upon by the public. Overall familiarity and adherence were quite high in most countries. Adherence was higher for social distancing recommendations compared to hygiene measures. Familiarity and adherence were higher among older, female, and highly educated respondents. However, country level heterogeneities were observed in the level of trust in information from the WHO, with countries severely affected by the pandemic reporting lower levels of trust.

CONCLUSION: Our findings call for efforts from health authorities to get regular feedback from the public on their familiarity and compliance with recommendations for preventive measures at all stages of the pandemic, to further develop and adapt risk communication as the pandemic evolves.

PMID:33914814 | DOI:10.1371/journal.pone.0250872

PLoS One. 2021 Apr 29;16(4):e0251000. doi: 10.1371/journal.pone.0251000. eCollection 2021.

ABSTRACT

BACKGROUND: The burden to fight with Corona Virus Disease-19 (COVID-19) pandemic has lied to frontline health care workers that are putting themselves at a higher risk in the battle against the disease. This study aimed to assess the exposure health risks of COVID-19 among frontline healthcare workers in the Amhara region, Ethiopia.

METHOD: A web-based cross-sectional study was conducted on public health workers from May to August 2020. Data were collected using a structured questionnaire via email and telegram services. Both descriptive statistics and bivariate followed by multivariable logistic regression analyses were conducted to identify distribution patterns and factors associated with exposure risks to COVID-19. Odds ratio with 95% Confidence Interval (CI), and a P-value of <0.05 was used to determine statistical significance.

RESULT: A total of 418 health care workers participated in the study with a response rate of 99.1%. The majority of the study participants 310(74.2%), were males, and 163(39%) were nurses/ midwives respectively. More than half of the respondents 237(56.7%), had reported that they didn`t have face-to-face contact with a confirmed COVID-19 patient. Among the respondents, 173(41.4%), 147(35.2%), 63(15.1%), and 65(15.6%) of the health professionals had always used gloves, medical masks, face shield, or goggles/protective glasses, and disposable gown, respectively. In this study, age between 25-34 years (AOR = 0.20), age between 35-44 years (AOR = 0.13), family size of >6 (AOR = 3.77), work experience of 21-30 years (AOR = 0.01), and good handwashing habit (AOR = 0.44) were the protective factors against COVID-19. On the other hand, perception of non-exposure to COVD 19 (AOR = 9.56), and poor habit of decontamination of high touch areas (AOR = 2.52) were the risk factors associated with confirmed COVID 19 cases among health care workers.

CONCLUSION: Poor adherence to personal protective equipment use and aseptic practices during and after health care interactions with patients were identified. Strategies should be implemented to institute effective and sustainable infection control measures that protect the health care workers from COVID-19 infection.

PMID:33914826 | DOI:10.1371/journal.pone.0251000

PLoS One. 2021 Apr 29;16(4):e0250814. doi: 10.1371/journal.pone.0250814. eCollection 2021.

ABSTRACT

BACKGROUND: Unsafe disposal of children’s stool makes children susceptible to fecal-oral diseases and children remain vulnerable till the stools of all children are disposed of safely. There is a paucity of data on spatial distribution and factors associated with unsafe child stool disposal in Ethiopia. Previous estimates, however, do not include information regarding individual and community-level factors associated with unsafe child stool disposal. Hence, the current study aimed (i) to explore the spatial distribution and (ii) to identify factors associated with unsafe child stool disposal in Ethiopia.

METHODS: A secondary data analysis was conducted using the recent 2016 Ethiopian demographic and health survey data. A total of 4145 children aged 0-23 months with their mother were included in this analysis. The Getis-Ord spatial statistical tool was used to identify high and low hotspots areas of unsafe child stool disposal. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant spatial clusters. A multilevel multivariable logistic regression model was fitted to identify factors associated with unsafe child stool disposal.

RESULTS: Unsafe child stool disposal was spatially clustered in Ethiopia (Moran’s Index = 0.211, p-value< 0.0001), and significant spatial SaTScan clusters of areas with a high rate of unsafe child stool disposal were detected. The most likely primary SaTScan cluster was detected in Tigray, Amhara, Afar (north), and Benishangul-Gumuz (north) regions (LLR: 41.62, p<0.0001). Unsafe child stool disposal is more prevalent among households that had unimproved toilet facility (AOR = 1.54, 95%CI: 1.17-2.02) and those with high community poorer level (AOR: 1.74, 95%CI: 1.23-2.46). Higher prevalence of unsafe child stool disposal was also found in households with poor wealth quintiles. Children belong to agrarian regions (AOR: 0.62, 95%CI 0.42-0.91), children 6-11 months of age (AOR: 0.65, 95%CI: 0.52-0.83), 12-17 months of age (AOR: 0.68, 95%CI: 0.54-0.86), and 18-23 months of age (AOR: 0.58, 95%CI: 0.45-0.75) had lower odds of unsafe child stool disposal.

CONCLUSIONS: Unsafe child stool disposal was spatially clustered. Higher odds of unsafe child stool disposal were found in households with high community poverty level, poor, unimproved toilet facility, and with the youngest children. Hence, the health authorities could tailor effective child stool management programs to mitigate the inequalities identified in this study. It is also better to consider child stool management intervention in existing sanitation activities considering the identified factors.

PMID:33914836 | DOI:10.1371/journal.pone.0250814

PLoS One. 2021 Apr 29;16(4):e0250778. doi: 10.1371/journal.pone.0250778. eCollection 2021.

ABSTRACT

INTRODUCTION: Pooling (or combining) and analysing observational, longitudinal data at the individual level facilitates inference through increased sample sizes, allowing for joint estimation of study- and individual-level exposure variables, and better enabling the assessment of rare exposures and diseases. Empirical studies leveraging such methods when randomization is unethical or impractical have grown in the health sciences in recent years. The adoption of so-called “causal” methods to account for both/either measured and/or unmeasured confounders is an important addition to the methodological toolkit for understanding the distribution, progression, and consequences of infectious diseases (IDs) and interventions on IDs. In the face of the Covid-19 pandemic and in the absence of systematic randomization of exposures or interventions, the value of these methods is even more apparent. Yet to our knowledge, no studies have assessed how causal methods involving pooling individual-level, observational, longitudinal data are being applied in ID-related research. In this systematic review, we assess how these methods are used and reported in ID-related research over the last 10 years. Findings will facilitate evaluation of trends of causal methods for ID research and lead to concrete recommendations for how to apply these methods where gaps in methodological rigor are identified.

METHODS AND ANALYSIS: We will apply MeSH and text terms to identify relevant studies from EBSCO (Academic Search Complete, Business Source Premier, CINAHL, EconLit with Full Text, PsychINFO), EMBASE, PubMed, and Web of Science. Eligible studies are those that apply causal methods to account for confounding when assessing the effects of an intervention or exposure on an ID-related outcome using pooled, individual-level data from 2 or more longitudinal, observational studies. Titles, abstracts, and full-text articles, will be independently screened by two reviewers using Covidence software. Discrepancies will be resolved by a third reviewer. This systematic review protocol has been registered with PROSPERO (CRD42020204104).

PMID:33914795 | DOI:10.1371/journal.pone.0250778

PLoS One. 2021 Apr 29;16(4):e0250955. doi: 10.1371/journal.pone.0250955. eCollection 2021.

ABSTRACT

BACKGROUND: Although the coronavirus disease 2019 (COVID-19) pandemic continues to rage worldwide, clinical and laboratory studies of this disease have been limited in many countries. We investigated the epidemiologic, clinical, and laboratory findings of COVID-19 infected patients to identify the effective indicators correlated with the disease.

METHODS: A retrospective study was conducted at King Abdullah Hospital in Bisha Province, Saudi Arabia, from March 20 to June 30, 2020. Patients of different age groups were confirmed as having COVID-19 infection using a real-time polymerase chain reaction. The demographic, clinical, and laboratory data of the patients were statistically analyzed.

RESULTS: Of the 132 patients, 85 were male and 47 were female, with a mean age of 50.9 years (SD±16.7). The patients were elderly (n = 29) and adults (n = 103). Of these, 54 (40.9%) had comorbidities, (25%) were admitted to the intensive care unit (ICU), and 12 (9.1%) died. On admission, the main clinical manifestations were fever (84.1%), cough (64.4%), shortness of breath (25%), chest pain (20.5%), and fatigue (18.2%). In all patients, increased neutrophils and decreased lymphocytes were observed. Patients’ lactate dehydrogenase (LDH) was elevated. C-reactive protein (CRP) was elevated in 48.5%, D-dimer in 43.2%, and the erythrocyte sedimentation rate (ESR) in 40.9% of patients. The elderly showed higher neutrophil (p = 0.011) and lower lymphocyte (p = 0.009) counts than adults. Glucose, creatine kinase-MB, LDH, bilirubin, D-dimer, and ESR were significantly higher in the elderly than in the adults. The COVID-19 death group had a higher leucocyte count (p = 0.036), and higher urea (p = 0.029) and potassium (p = 0.022) than the recovered group but had a lower hemoglobin concentration (p = 0.018). A significant association was determined between COVID-19 death and the presence of cardiovascular disease (χ2(1) = 16.297, p<0.001), hypertension (χ2(1) = 12.034, p = 0.001), renal failure (χ2(1) = 3.843, p = 0. 05), old age (t (130) = 4.9, p <0.001), and ICU admission (χ2(1) = 17.6 (1), p<0.001).

CONCLUSIONS: Investigating some of the laboratory and clinical parameters could help assess the disease progression, risk of mortality, and follow up patients who could progress to a fatal condition.

PMID:33914805 | DOI:10.1371/journal.pone.0250955

PLoS One. 2021 Apr 29;16(4):e0250826. doi: 10.1371/journal.pone.0250826. eCollection 2021.

ABSTRACT

We report on the results of a measurement study carried out on a commuter bus in Dublin, Ireland using the Google/Apple Exposure Notification (GAEN) API. This API is likely to be widely used by Covid-19 contact tracing apps. Measurements were collected between 60 pairs of Android handset locations and are publicly available. We find that the attenuation level reported by the GAEN API need not increase with distance between handsets, consistent with there being a complex radio environment inside a bus caused by the metal-rich environment. Changing the people sitting in a pair of seats can cause variations of ±10dB in the attenuation level reported by the GAEN API. Applying the rule used by the Swiss Covid-19 contact tracing app to trigger an exposure notification to our bus measurements we find that no exposure notifications would have been triggered despite the fact that all pairs of handsets were within 2m of one another for at least 15 mins. Applying an alternative threshold-based exposure notification rule can somewhat improve performance to a detection rate of 5% when an exposure duration threshold of 15 minutes is used, increasing to 8% when the exposure duration threshold is reduced to 10 mins. Stratifying the data by distance between pairs of handsets indicates that there is only a weak dependence of detection rate on distance.

PMID:33914810 | DOI:10.1371/journal.pone.0250826

Indian J Ophthalmol. 2021 May;69(5):1178-1182. doi: 10.4103/ijo.IJO_976_20.

ABSTRACT

PURPOSE: To study the effect of smoking on tear film parameters and retinal nerve fiber layer thickness (RNFL) in chronic smokers.

METHODS: This was a cross-sectional study, which included 60 (120 eyes) smokers who have smoked at least 10 pack-year and an equal number of healthy subjects as a control for comparison. In addition to history, a detailed slit-lamp examination was done to evaluate the anterior and posterior segments. All patients underwent Schirmer’s I test (SIT) with Whatman-41 filter paper, tear meniscus height (TMH), and RNFL with a Fourier-domain optical coherence tomography (OCT) and tear film breakup time (TBUT) with 2% fluorescein and cobalt blue filter using slit-lamp biomicroscopy.

RESULTS: The (mean ± SD) age of the participants was 56.48 ± 10.38 years. There was a statistically significant reduction in tear film parameters in smokers compared to nonsmokers (P = 0.000). The incidence of MGD was found to be higher in smokers when compared to nonsmokers with a P value of 0.000. RNFL in all four quadrants was also significantly reduced in smokers compared to nonsmokers (P = 0.00).

CONCLUSION: This study shows that chronic smoking leads to an increased incidence of dry eye disease and is associated with RNFL thinning. Smoking can result in cumulative RNFL loss in patients with ocular neurodegenerative disorder and OCT of these patients may have to be interpreted keeping this in mind.

PMID:33913855 | DOI:10.4103/ijo.IJO_976_20

Anal Methods. 2021 Apr 29;13(16):1925-1929. doi: 10.1039/d1ay00240f.

ABSTRACT

Our study involved a simple, sensitive voltammetric method of determining either carbonate or bicarbonate ions independently with azomethine-H and a disposable pencil graphite electrode. The reduction of azomethine-H-carbonate complexes at approximately -930 mV formed in acetic acid-acetate buffer solution (pH: 4.25) was evaluated as a response. Among the results, the limits of detection and analytical ranges for carbonate ions were 3.7 μg L-1 and 9.9-700.0 μg L-1 and for bicarbonate ions were 9.0 μg L-1 and 35.0-700.0 μg L-1, and the relative standard deviations for carbonate and bicarbonate ions ranged from 1.33% and 6.93% at different concentrations. After the proposed method was applied to water, sparkling water, seawater and baking powder samples, the results were statistically evaluated and compared with those obtained from the potentiometric auto-titration system. Last, the complex stoichiometry of both carbonate and bicarbonate ions was comprehensively investigated with fluorescence and 1H-NMR spectroscopy.

PMID:33913940 | DOI:10.1039/d1ay00240f

Indian J Ophthalmol. 2021 May;69(5):1068-1072. doi: 10.4103/ijo.IJO_2649_20.

ABSTRACT

PURPOSE: Earlier our group has demonstrated the drug reservoir function of the human amniotic membrane (HAM) using stable moxifloxacin and fortified cefazolin ophthalmic formulations and found it as a suitable tool to deliver drugs for an extended duration. The purpose of this study was to evaluate the extended-release kinetics of voriconazole from the impregnated human amniotic membrane (HAM) in vitro.

METHODS: HAM buttons were incubated with freshly prepared 1% topical ophthalmic formulation of voriconazole for 5 different exposure time to investigate the ideal exposure time for the extended-release of voriconazole from HAM. The drug release kinetics was studied in simulated tear fluid for 5 weeks and the amount of voriconazole released at different intervals was estimated using high-performance liquid chromatography (HPLC) with photodiode array (PDA) detector.

RESULTS: There was a marginal increase in drug entrapment efficiency with increased drug exposure time but neither the drug entrapment nor the drug release was found to be statistically significant (P ≥ 0.5). Voriconazole was detectable even at 5 weeks.

CONCLUSION: A sustained release of voriconazole was achieved up to 5 weeks, when voriconazole was incubated with amniotic membrane for all the studied drug soaking times. Thus, voriconazole impregnated amniotic membrane can be considered for the sustained delivery for its in fungal keratitis.

PMID:33913834 | DOI:10.4103/ijo.IJO_2649_20

Indian J Ophthalmol. 2021 May;69(5):1120-1126. doi: 10.4103/ijo.IJO_1191_20.

ABSTRACT

PURPOSE: Evaluation of circumpapillary vessel density (VD) and perfusion density (PD) on optical coherence tomography angiography (OCTa) in mild-moderate glaucoma patients having unilateral visual field defects, with their fellow eyes and controls.

METHODS: Both eyes of 24 patients having a definitive nasal step or arcuate scotoma in one hemisphere of one eye only, and 24 controls, underwent OCTa.

RESULTS: In eyes with a superior field defect, the superior/inferior quadrant ratios, (SQ/IQ) of 3 mm scan of VD and PD were significantly higher in eyes with a superior arcuate scotoma than fellow eyes (P = 0.03,0.02) as also controls, (P = 0.004,0.001). The mean percentage loss of inferior quadrant VD between control to fellow eyes, and superior nasal step eyes were similar, 20.19%/19.57% respectively, P = 0.85, while a loss in arcuate scotoma eyes was 38.81% (P = 0.001). The percentage decrease in inferior quadrant PD in fellow eyes was 14.70%, superior nasal step 23.39%, and an arcuate scotoma 34.74% (P = 0.02). Eyes with a superior nasal step had significantly lower VD and PD absolute values in the inferior quadrant OCTa in 3 mm and 6 mm circle scan only as compared to control eyes, VD, P = 0.03,0.04/PD, P = 0.008,0.02. Fellow eyes of superior field defects had significantly lower VD and PD absolute values in the inferior quadrant in 3 mm and 6 mm circle scan as compared to control eyes, VD, P = 0.006,0.04/PD, P = 0.01,0.03. Eyes with an isolated inferior field defect in only one eye, showed a significant decrease in both VD and PD in all quadrants as compared to fellow eyes and control eyes. A significant positive correlation was found between VD and RNFL thickness in peripapillary superior unaffected quadrants in eyes with superior field defects and inferior unaffected quadrants in inferior defects (P = 0.001 and 0.01).

CONCLUSION: There was a statistically significant increasing SQ/IQ ratio and percentage loss of vascular parameters from control to fellow eyes, those with a superior nasal step, and those with a superior arcuate scotoma. Inferior VFDs appeared to be associated with a more generalized circulatory loss. The asymmetry between hemispheres and between eyes could be used as a biomarker for early glaucomatous neuropathy.

PMID:33913845 | DOI:10.4103/ijo.IJO_1191_20